NPI | 1013094119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 19030) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 19030) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 19030) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2022-07-21 |